Necessity to define thyroid reference values for better clinical interpretation

Plouvier, Elisabeth; Alliot, Laurent; Bigorie, B; Kowalski, Caroline; Médeau, V.; Thuillier, F.

doi:10.1684/abc.2010.0517

Cited by 1 publication

(1 citation statement)

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“…It is important to note that the lower limit value avoids the consideration of false subclinical hyperthyroidism in the first trimester if TSH is > 0.128 mIU/L, taking into account that our lower limit value for the general population is 0.27 mIU/L. Some authors [28] have stated that TSH levels follow a circadian rhythm, with a peak during the night that drops during the morning, a circumstance that must be taken into consideration when performing blood extractions, as we did in our case.…”

Section: Discussionmentioning

confidence: 99%

Reference Values of Thyroid Hormones During the First Trimester of Pregnancy in Valencian Community (Spain) and Their Relationship with Iodine Intake

2020

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Thyroid hormones require special monitoring during the first trimester of gestation. Local reference values should be applied if available, especially in iodine-deficient areas, as generalized iodine supplementation is controversial. The aim of the present study was to establish thyroid stimulating hormone (TSH) and free thyroxine (FT4) reference values in the first trimester of gestation in the Valencian community (Spain) and relate them to iodine intake. A total of 261 healthy pregnant women participated in the study. The calculated reference values were 0.128–4.455 mIU/L for TSH and 0.9–1.592 ng/dL for FT4. The upper TSH reference value for pregnant women in the first trimester in our environment was similar to the latest American Thyroid Association (ATA) recommendation (4 mIU/L). The mean TSH value was significantly lower in smokers, and there were no significant differences when analyzing the influence of iodine supplementation, although the low duration of supplement intake needs to be taken into consideration. Ioduria levels (median 57 µg/L) confirmed iodine deficiency. We found statistically significant differences in ioduria levels among patients who consumed iodized salt and iodine supplements and those who did not. It is essential to focus on recommending adequate consumption of iodized salt and iodine supplements prior to gestation and at least during the first trimester to avoid possible maternal thyroid dysfunction and perinatal complications.

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Section: Discussionmentioning

confidence: 99%